Primary care providers are in a unique position to incorporate oral health care in their practices. Oral health anticipatory guidance fits nicely with the emphasis on prevention and early establishment of lifelong healthy habits.
The information presented here is designed as a starting point for providers to incorporate oral health education into their practices. We have included information on common dental conditions, oral health in the office and resources and referrals for providers and families.
ORAL HEALTH IN YOUR OFFICE
Common Dental Problems and Emergencies
- Dental injuries – a self-guided overview (PowerPoint)
- Ankyloglossia and sublingual frenotomy: ARTICLE and ALGORITHM GRAPHIC
- Lip Tie
- Extra Teeth
Fluoride Information and Services
Sedation for Dental Procedures
Dental Sedation Information for Providers and Families
Guidelines for Monitoring & Management of Pediatric Patients Before, During and After Sedation for Diagnostic and Therapeutic Procedures
ORAL HEALTH CASES
Case of the week: Open Bite
You are seeing a 3-year-old boy for a well-child visit. His mother asks why the boy’s back teeth come together but the front teeth do not (see dentist-provided photo below). How do you describe this physical finding? What questions do you have for the boy’s parents? What do you recommend?
This is an anterior open bite, caused by, in this case, ongoing pacifier use in this 3 year old. When asked, the boy’s parents describe that their son uses the pacifier throughout the day and at night.
Non nutritive sucking (on pacifiers and digits) can be beneficial in the first year of life but beyond that, sucking habits can adversely affect occlusion, as seen in this case. Ideally, pacifiers and other sucking habits would be discontinued by 12 to 18 months of age.
There is some research evidence that malocclusion from a sucking habit may spontaneously resolve if the habit is discontinued by 4 to 6 years of age. At 3 years, this child’s anterior open bite could resolve if the pacifier is discontinued. Treatment of an anterior open bite in an older child can be costly and treatment intensive so it is better to act now and counsel parents to discontinue the pacifier. There are numerous strategies for doing so described online, ranging from going “cold turkey” to gradually decreasing use over time. There are also books and videos about getting rid of the pacifier that are geared towards young children, and these may appeal to some families.
Silva M, Manton D. Oral habits–part 1: the dental effects and management of nutritive and non-nutritive sucking. J Dent Child (Chic) 2014; 81(3): 133-9.
Warren JJ, Slayton RL, Bishara SE, Levy SM, Yonezu T, Kanellis MJ. Effects of nonnutritive sucking habits on occlusal characteri- stics in the mixed dentition. Pediatr Dent 2005; 27(6): 445-50.